Impending paradoxical cerebral embolism in a patient with atrial septal aneurysm.

There is increasing emphasis on the role of interatrial septal abnormalities, including patent foramen ovale and atrial septal aneurysm, in the genesis of stroke. However, a transseptal thrombus located in both atria is rarely visualized by echocardiography or other cardiac imaging techniques. It is also difficult to prove the mechanism of stroke in most clinical settings.

Reversible left ventricular dysfunction "takotsubo" cardiomyopathy associated with hyperthyroidism.

Myocardial stunning with hyperthyroidism is rare. A 79-year old woman with hyperthyroidism was admitted to our hospital complaining of palpitations due to paroxysmal atrial fibrillation. An echocardiogram showed akinesis of the apical wall which was not observed 2 weeks before admission.

Enhancement of J-ST-segment elevation by the glucose and insulin test in Brugada syndrome.

The effects of glucose and insulin on J-ST-segment elevation were evaluated in seven men (mean age 45 +/- 10 years) with Brugada syndrome. Six patients had been reanimated from VF and one patient had experienced syncope. The effects of intavenous (1) pilsicainide 50 mg, (2) glucose 50 g, and (3) glucose 50 g plus regular insulin 10 IU on the precordial ECG leads were examined.